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SLEEP DISORDERS - TREATMENT

OBSTRUCTIVE SLEEP APNEA CPAP INTOLERANCE PEDIATRIC SLEEP PROBLEMS SNORING

 

OBSTRUCTIVE SLEEP APNEA

Obstructive Sleep Apnea (OSA) is a serious health concern.

GET THE FACTS!

  • OSA is a common condition, affecting up to 10% of the population.
  • Rates of OSA are
    2x-4x higher after age of 50.
  • Mild to moderate sleep apnea patients are the most likely not to be screened.
  • Untreated sleep apnea can put you at increased risk of developing:
    • Hypertension
    • Heart disease
    • Stroke
    • Diabetes
There are 3 major approaches to treating Obstructive Sleep Apnea (OSA):

1. Dental Appliance Therapy

Similar in appearance to an athletic mouthguard, these splint-like devices are placed in the mouth during sleep to prevent the blocking of the airway. They function by reposturing the mandible, tongue, soft palate, hyoid bone and by stabilizing the lower jaw.

When properly customized for patients by qualified dental professionals, sleep appliances are easy to use, relatively inexpensive and extremely effective in treating mild to moderate OSA. New research is also showing that patients with severe OSA, including those who are CPAP intolerant and/or not candidates for surgery, can also benefit greatly by using a dental sleep appliance

2. Nasal CPAP (continuous positive air pressure)

A Nasal CPAP unit is a machine that delivers lightly pressurized air through a hose that is hooked to a small nose mask that you must wear when you sleep. The flow of the air acts like an “air splint,” keeping your upper airway open and preventing apnea.

Patients who use Nasal CPAP units experience almost immediate and nearly total relief of their OSA symptoms. Despite its effectiveness, however, the rate of patient compliance with nasal CPAP therapy is extremely low.

3. Surgery

In severe cases, your physician may recommend removal of throat tissues, such as the soft palate, tonsils and adenoids, to enlarge your airway opening. While this may be your best treatment option, we urge patients to consider a) the risks inherent in surgery of any type, b) the long-term prognosis since removed tissues can grow back, and c) the availability of non-surgical therapies.

TAKE NOTE: Whether or not you have OSA is best confirmed by a referral from your physician to an overnight sleep lab for a diagnostic polysomnographic study. We are happy to provide the names of sleep medicine physicians as well as sleep labs that we work with, upon request.

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CPAP INTOLERANCE

Dissatisfied with CPAP?

GET THE FACTS!

  • CPAP is an extremely effective therapy; however, nationally only 45% of patients using CPAP machines continue to use them.
  • The American Sleep Disorders Associa-tion is recommending dental appliance treatment for patients with severe OSA who are intolerant of, or refuse treatment with, CPAP.
CPAP Intolerance Affidavits are helping increasing numbers of sleep patients to seek oral therapies through their insurance carriers.
What is Nasal CPAP?

A Nasal CPAP (continuous positive airway pressure) machine delivers lightly pressurized air through a hose to a small nose mask. The flow of the air acts like an “air splint” to keep the upper airway open and prevent apnea (i.e., shortness of breath). CPAP machines have 99% efficiency in restoring normal breathing during sleep. They have also undergone many improvements since an Australian invented the first one from a vacuum cleaner and a length of hose. However, the rate of patient compliance with CPAP is less than 50%.

Are There Alternatives to CPAP?

Yes! Thanks to advances in dental sleep medicine, qualified dentists can effectively treat many patients who suffer from snoring, obstructive sleep apnea, upper airway resistance syndrome and other sleep-disordered breathing problems using oral appliance therapy.

An oral sleep appliance is similar in appearance to an athletic mouthguard, and it is worn during sleep to maintain airway patency. Oral sleep appliances are safe, less expensive vs. CPAP or surgery, and easy to use. There are also few, if any, side effects. However, one size does not fit all.

There are currently six (6) different FDA-approved oral appliances we can use to treat sleep-disordered breathing. Regardless of the appliance selected, to be effective, it must be properly customized and precision fit for each patient.

For some patients, an oral sleep appliance can eliminate the need for CPAP or surgery. For patients with more severe sleep problems, an oral appliance can be an effective and convenient adjunct therapy.

Take Note: To find out if oral appliance therapy can help improve the quality and quantity of your sleep, consult a dentist who is certified in dental sleep medicine. Seeing your “regular dentist” may not be adequate since all dentists do not possess the necessary training or expertise.

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PEDIATRIC SLEEP PROBLEMS

Pediatric Sleep Disorders Linked to Health & Behavior Issues

GET THE FACTS!

  • 81% of snoring children with ADHD could have their ADHD eliminated if their habitual snoring were effectively treated. (Chervin, R.D., et.al., Symptoms of Sleep Disorders, Inattention and Hyperactivity in Children, 1997, Sleep 20(12): 1185-1192).
  • Using a dental sleep appliance can eliminate the need for surgical removal of the tonsils in some cases.
Nighttime bedwetting ceased in 10 cases studied when oral therapies were used to reduce nasal constriction. (Timms, D., Rapid Maxillary Expansion in the Treatment of Nocturnal Enuresis. The Angle Orthodontist, 1990, 60(3):

 

Unlike adults, children who suffer from
sleep-disordered breathing are often likely to exhibit
hyperactivity during the day.

Restful Sleep is Essential to Your Child’s Health

Undiagnosed and untreated pediatric sleep disorders have been linked to a spectrum of health and behavioral issues, including

  • Attention hyperactivity deficit disorder (ADHD)
  • Nocturnal enuresis (nighttime bed wetting)
  • Weight gain or obesity
  • Nightmares and
  • Bedtime resistance

Traditional Treatment Options

Traditionally, physicians have treated pediatric sleep disorders with CPAP machines and/or surgery to remove the tonsils and adenoids. Due to advances in dental sleep medicine, today there are more conservative, yet equally effective therapies available from qualified dentists.

Conservative, Effective Dental Treatment Options

Certified in dental sleep medicine, we can often treat sleep-disordered breathing problems in children by providing them with a custom-made dental sleep appliance (similar to an athletic mouthguard) or by placing temporary ceramic crowns on their teeth. These crowns effectively open up the child’s bite and maintain a natural, open airway during sleep.

We also work with parents to improve their children’s sleep habits and will leverage our relationships with area sleep medicine specialists when a multidisciplinary approach to your child’s care is warranted.
TAKE NOTE: Discussing your child’s sleep problems with your regular dentist may not be helpful, since all dentists do not have advanced training or expertise in the field of dental sleep medicine.
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SNORING

SNORING
is no laughing matter.

GET THE FACTS!

  • 60% of males and 40% of females over the age of 60 snore.
    (Female snoring increases after menopause.)
  • The loudness of snoring may reach as high as 90 db.
    (Worker’s compensation requires ear protection in the workplace at 90 db.)
  • 98.5% of snorers exhibit some apneic tendencies.
Snoring can lead to sleep apnea because it can change tissue structure.
In recent clinical studies, dentists and physicians have found that, in the majority of patients, a well-made, well-fitted dental appliance will effectively reduce or eliminate snoring.

What is a Dental Sleep Appliance?

A dental appliance is a small, biocompatible acrylic device that is similar to an orthodontic retainer or athletic mouthguard. It is worn in the mouth during sleep to prevent the soft throat tissues from collapsing and obstructing the airway.

How Does a Dental Sleep Appliance Work?

Dental appliances provide an effective, conservative approach to managing snoring (and other sleep-disordered breathing problems) by:

  • Bringing the lower jaw open and forward,
  • Holding the tongue forward, and
  • Lifting the drooping soft palate.

There are 20+ types of mandibular repositioners. All maintain airway patency by holding the mandible (lower jaw) in a protruded position during sleep. Many can be adjusted quickly and easily, offering clear advantages to patients in terms of cost, effectiveness, comfort and ease of use.

Tonque retaining devices are particularly helpful for those patients who have temporomandibular joint dysfunction. These devices hold the tongue in a forward position during sleep – without placing stress on the teeth or the TM joint.

TAKE NOTE: The success of dental appliance therapy is an important development in sleep disturbance. However, such therapy should never be undertaken in the absence of a joint working relationship between your referring physician and a dentist with advanced training in dental sleep medicine. To ensure continuity of care for our patients, at Craniofacial Pain Associates of Oklahoma, we also work closely with the area’s leading sleep medicine physicians.

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448 36th Avenue N.W., Suite 103, Norman OK 73072 • 800/622-1974 or 405/321-8030 (ph) • 405/321-2108 (fax)